Dig Liver Dis. 2021 Mar;53(3):283-288. doi: 10.1016/j.dld.2020.12.011.Epub 2020 Dec 26.

Serena Arrigo ¹, Patrizia Alvisi ², Claudia Banzato ³, Matteo Bramuzzo ⁴, Rosaria Celano ⁵, Fortunata Civitelli ⁶, Giulia D'Arcangelo ⁷, Anna Dilillo ⁸, Valeria Dipasquale ⁹, Enrico Felici ¹⁰, Maurizio Fuoti ¹¹, Simona Gatti ¹², Daniela Knafelz ¹³, Paolo Lionetti ¹⁴, Federica Mario ¹⁵, Antonio Marseglia ¹⁶, Stefano Martelossi ¹⁵, Chiara Moretti ¹⁷, Lorenzo Norsa ¹⁸, Roberto Panceri ¹⁹, Sara Renzo ¹⁴, Claudio Romano ⁹, Erminia Romeo ²⁰, Caterina Strisciuglio ²¹, Massimo Martinelli ²²

Author information

• ¹Pediatric Gastroenterology and Endoscopy Unit, Institute 'Giannina Gaslini', Genoa, Italy.
• ²Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy.
• ³Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy.
• ⁴Institute for Maternal and Child Health, IRCCS Burlo Garofalo, Trieste, Italy.
• ⁵Fondazione IRCCS Ca' Grande, Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, Milan, Italy.
• ⁶Department of Gender diseases, Child and Adolescent health, Pediatric unit, Sant'Eugenio Hospital, Rome, Italy.
• ⁷Women's and Children's Health Department, Pediatric Gastroenterology and Hepatology Unit, Sapienza University of Rome, Rome, Italy.
• ⁸Pediatric and Neonatology Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy.
• ⁹Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adult and Developmental Age ``Gaetano Barresi'', University of Messina, Italy.
• <sup>10</sup>Pediatric and Pediatric Emergency Unit, "Umberto Bosio" Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy.
• <sup>11</sup>Pediatric Gastroenterology and GI Endoscopy, University Department of Pediatrics, Children's Hospital, Spedali Civili, Brescia, Italy.
• <sup>12</sup>Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy.
• <sup>13</sup>Hepatology and Gastroenterology Unit, Bambino Gesù Hospital, Rome, Italy.
• <sup>14</sup>University of Florence-Meyer Hospital, Florence, Italy.
• <sup>15</sup>Pediatric Unit, Ca' Foncello's Hospital, Treviso, Italy.
• <sup>16</sup>Fondazione IRCCS Casa Sollievo della Sofferenza, Division of Pediatrics, San Giovanni Rotondo, Italy.
• <sup>17</sup>Paediatrics Division, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
• <sup>18</sup>Paediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy.
• <sup>19</sup>Department of Pediatrics, University of Milano-Bicocca, Foundation MBBM/San Gerardo Hospital, Monza, Italy.
• <sup>20</sup>Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
• <sup>21</sup>Department of Woman, Child and General and Specialistic Surgery, University of Campania ``Luigi Vanvitelli'', Naples, Italy.
• ²²Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Italy. Electronic address: massimo.martinelli@unina.it.

Abstract

Background: IBD management has been significantly affected during the COVID-19 lockdown with potential clinical issues.

Aims: The aim of this study was to analyse the impact of COVID-19 pandemic on the Italian paediatric IBD cohort.

Methods: This was a multicentre, retrospective, cohort investigation including 21 different Italian IBD referral centres. An electronic data collection was performed among the participating centres including: clinical characteristics of IBD patients, number of COVID-19 cases and clinical outcomes, disease management during the lockdown and the previous 9 weeks.

Results: 2291 children affected by IBD were enrolled. We experienced a significant reduction of the hospital admissions [604/2291 (26.3%) vs 1281/2291 (55.9%); p < 0.001]. More specifically, we observed a reduction of hospitalizations for new diagnosis (from n = 44 to n = 27) and endoscopic re-evaluations (from n = 46 to n = 8). Hospitalization for relapses and surgical procedures remained substantially unchanged. Biologic infusions did not significantly vary [393/2291 (17.1%) vs 368/2291 (16%); p = 0.3]. Telemedicine services for children with IBD were activated in 52.3% of the centres. In 42/2291(1.8%) children immunosuppressive therapies were adapted due to the concurrent COVID-19 pandemic.

Conclusion: Due to the several limitations of the lockdown, cares for children with IBD have been kept to minimal standards, giving priorities to the urgencies and to biologics' infusions and implementing telemedicine services.